Alzheimer's Self Test Works Surprisingly Well

Human brains are about three times as large as those of our early australopithecines ancestors that lived 4 million to 2 million years ago, and for years, scientists have wondered how our brains got so big. A new study suggests social competition could be behind the increase in brain size.Credit: NIH, NIDA

A newly developed handwritten test designed to assess
cognitive abilities in older adults could one day serve as a tool to help
detect Alzheimer's disease in its early stages, new research suggests.

While previous pen-and-paper tests have been developed to
help identify memory problems, most of them require a doctor to administer it.
The new test, on the other hand, is self-administered.

"A lot of people, unfortunately, with cognitive issues don't
tell their doctors, they hide it or they don't think it's a big problem, so
they don't bring it up. And primary care doctors are so busy that they're not
just going to screen someone and take 10 or 15 minutes of their time or their
nurses' time to do a test," said Dr. Douglas Scharre, a neurologist at
Ohio State University Medical Center, who developed the test. "So this is
a way to perhaps identify people early, or make it easier to identify
people early because of the self-administered nature of this test."

Why it matters

Catching Alzheimer's
early could shorten the time between when patients start to have disease
symptoms and when they go to their doctor about it, which is on average three
and a half years, Scharre said. Such a lag prevents patients from starting
medications, which, while not a cure, work best if they are begun early. And
unidentified mental impairment can lead to further health problems, such as
when patients with diabetes forget to take their insulin.

However the test cannot diagnose
Alzheimer's or distinguish this condition from other types of dementia. (While
dementia
is a symptom that means someone is not thinking well, Alzheimer's is a specific
type of dementia thought to be caused by toxic proteins accumulated in specific
brain areas.)

Rather, the test serves as more of a starting point for
further examination.

"It's not a diagnostic test, it won't tell you what the
cause of their brain problem is, but it would at least give a doctor a hint of,
'Hey maybe something's up, let me think about this more [and] let me look at this
more,'" Scharre said.

Test your brain

The self test, known as Self-Administered Geocognitive
Examination or SAGE, is designed to test various parts of the brain linked to certain
functions. For example, patients are asked to identify pictures to test their
language skills, and perform calculations to test their math skills, both
primarily carried out by the left side of the brain. Subjects also copy
geometrical designs to test their right brain, and perform memory tests. The
SAGE test is quite robust compared to other handwritten tests in that it
measures so many different parts of the brain, Scharre said.

In a study involving 254 participants, Scharre and his colleagues
compared the reliability of the SAGE test with that of other standard tests
used to detect cognitive problems, such as assessment by a neuropsychologist. The
results show 80 percent of those with mild thinking and memory issues can be
detected by SAGE, and 95 percent of those with normal thinking abilities will
have normal scores.

Other advantages of SAGE include its low price tag, costing
just pennies for paper and ink, and the fact that it's completed on paper
rather than on a computer, which might confuse some older adults who are not
familiar with the technology.

Don't try this at
home

Like all self-administered tests, this one has its
down-sides. Patients can't be timed, so their scores on SAGE aren't directly
comparable to other standardized tests that are timed. And subjects could cheat
by looking at calendars or clocks (items on the test) that might be in view.

And while the test is currently available for health
professional to download, Scharre doesn't recommend that people take it at
home. It's important to have a doctor or other healthcare personnel figure out
a patient's score and interpret the results, Scharre said.

Also, patients might be embarrassed to admit they have a
mental illness, and might be tempted to cheat on their own, he said.

Scharre plans to carry out more studies with his tests,
specifically looking at how people's scores change over time.

The results were published in March in the journal Alzheimer
Disease and Associated Disorders.

Rachael Rettner

Rachael has been with Live Science since 2010. She has a masters degree in journalism from New York University's Science, Health and Environmental Reporting Program. She also holds a Bachelor of Science in molecular biology and a Master of Science in biology from the University of California, San Diego.